Recent data out of Kentucky, which has one of the best performing exchange websites in the U.S., show that the average age of enrollees is about 51, ten years above expectations. To insure these higher cost individuals, premiums will have to "skyrocket" and this leads to the so called "death spiral."
This happened in New York, New Jersey and Massachusetts where young people opted out of the system as a whole because of high prices.
“As premiums rose, healthy people dropped out meaning the risk pool was high,” Herrick says. “Premiums rose again, and more healthy people dropped out. The costs for individual insurance were double and triple the national average.”
If President Obama had read Chapter 19, he would have known to anticipate this kind of adverse selection.
Don't worry though, I am sending him a copy of my book.